Deficiencies (last 3 years)
Deficiencies (over 3 years)
3.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
20% better than Wisconsin average
Wisconsin average: 4.6 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
56 residents
Based on a August 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Complaint Investigation
Census: 56
Deficiencies: 0
Date: Aug 19, 2025
Visit Reason
Surveyors conducted a complaint investigation at Amery Memory Care based on two complaints.
Complaint Details
Two complaints were investigated and both were found to be unsubstantiated.
Findings
Two of the two complaints were unsubstantiated and no new citations were identified during the investigation.
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Jun 2, 2025
Visit Reason
A complaint and self-report investigation was conducted on June 2, 2025, to determine if Amery Memory Care was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
The investigation was complaint and self-report based, concluded on June 2, 2025, to assess compliance with applicable statutes and codes. The Department issued a Statement of Deficiency and imposed enforcement actions including forfeiture.
Findings
The Department of Health Services issued a Statement of Deficiency (SOD #Y2XJ11) identifying violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83. The licensee was ordered to comply with requirements immediately and implement corrective measures to ensure adequate personal care services for all residents.
Deficiencies (1)
Violations of Wis. Stat. ch. 50 or Wis. Admin. Code ch. DHS 83 as identified in Statement of Deficiency #Y2XJ11
Report Facts
Forfeiture amount: 1200
Forfeiture amount: 450
Forfeiture amount: 200
Forfeiture amount: 550
Forfeiture payment reduction: 780
Compliance timeframe: 45
Payment timeframe: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| William R. Gardner | Assisted Living Regional Director | Contact person for questions about the letter |
| Kenneth Brotheridge | Assisted Living Director | Signed the notice letter |
Inspection Report
Complaint Investigation
Census: 56
Capacity: 68
Deficiencies: 3
Date: Jun 2, 2025
Visit Reason
Surveyors conducted a self-report and complaint investigation at Amery Memory Care from 05/21/2025 through 06/02/2025 following complaints received regarding resident care and medication administration.
Complaint Details
Three of five complaints were substantiated. Complaints included failure to notify family of injury, improper medication administration, and inadequate care. The injury to Resident 2 was discovered on 01/26/2025 but was not reported to family or hospice until 02/05/2025. Resident 1 was observed without prescribed oxygen multiple times.
Findings
Three of five complaints were substantiated, resulting in three violations, two of which were repeat deficiencies. Key findings included failure to immediately notify resident's legal representative and physician of an injury, failure to administer medication as prescribed, and failure to provide adequate and appropriate care within the facility's capacity.
Deficiencies (3)
Provider did not immediately notify Resident 2's legal representative and physician when Resident 2 sustained a skin tear injury.
Provider did not ensure Resident 1's medication (oxygen) was administered as prescribed.
Provider did not ensure every resident received adequate and appropriate care within the capacity of the facility, including prompt treatment and follow-up of injuries.
Report Facts
Complaints substantiated: 3
Violations identified: 3
Repeat violations: 2
Census: 56
Total licensed capacity: 68
Skin tear injury size: 5
Skin tear injury size: 4
Oxygen flow rate: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrator D | Administrator | Provided investigation and statements regarding injury notification and medication administration |
| Resident Health Coordinator B | Resident Health Coordinator | Interviewed regarding injury notification and oxygen use observations |
| Resident Health Coordinator C | Resident Health Coordinator | Interviewed regarding injury notification and oxygen use observations |
| Resident Care Coordinator E | Resident Care Coordinator | Discovered Resident 2's injury and completed skin assessment and observation notes |
| Senior Administrator J | Senior Administrator | Interviewed regarding management oversight of injury notification |
Inspection Report
Complaint Investigation
Census: 58
Deficiencies: 0
Date: Jan 21, 2025
Visit Reason
The Department conducted a complaint investigation at Amery Memory Care.
Complaint Details
The complaint was unsubstantiated.
Findings
The complaint was unsubstantiated and no violations were identified during the investigation.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Jul 17, 2024
Visit Reason
A standard survey, complaint investigation, and verification visit was conducted to determine if Amery Memory Care was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
The visit included a complaint investigation and verification of prior deficiencies. The substantiation status is not explicitly stated.
Findings
The Department issued a Statement of Deficiency (SOD) #QKNG15 for violations found during the inspection. A verification visit was also conducted to determine if prior violations in SOD #QKNG14 were corrected, resulting in the assessment of a $200 inspection fee.
Report Facts
Inspection fee: 200
Appeal filing deadline: 10
Compliance correction timeframe: 45
Employees mentioned
| Name | Title | Context |
|---|---|---|
| William R. Gardner | Assisted Living Regional Director | Contact person for questions about the letter. |
| Kenneth Brotheridge | Assisted Living Director | Signed the notice letter. |
Inspection Report
Complaint Investigation
Census: 55
Deficiencies: 1
Date: Jul 11, 2024
Visit Reason
The surveyor conducted a standard survey, verification visit, and complaint investigation at Amery Memory Care on 07/11/2024.
Complaint Details
Two complaints were investigated and both were unsubstantiated.
Findings
Two of two complaints were unsubstantiated. One violation was identified related to the provider not ensuring an annual fire inspection was completed in 2023.
Deficiencies (1)
The provider did not ensure an annual fire inspection was completed in 2023.
Report Facts
Revisit fee: 200
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Administrator A | Interviewed regarding fire inspections and responsible parties. | |
| Environmental Services Coordinator B | Responsible for ensuring annual fire inspections were completed. |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Dec 6, 2023
Visit Reason
A verification visit and complaint investigation was conducted on December 6, 2023, to determine if Amery Memory Care was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
The visit was complaint-related and included a verification visit to determine compliance. The Department found violations and issued a Statement of Deficiency.
Findings
The Department issued a Statement of Deficiency (SOD #QKNG14) for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a forfeiture of $600 and an order to comply with requirements to protect resident health, safety, and welfare.
Deficiencies (1)
Violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83 as identified in SOD #QKNG14
Report Facts
Forfeiture amount: 600
Reduced forfeiture amount: 390
Inspection fee: 200
Compliance timeframe: 45
Payment timeframe: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| William R. Gardner | Assisted Living Regional Director | Contact person for questions about the letter |
| Kenneth Brotheridge | Assisted Living Director | Signed the Notice and Order letter |
Inspection Report
Complaint Investigation
Census: 48
Capacity: 68
Deficiencies: 1
Date: Nov 20, 2023
Visit Reason
The inspection was conducted as a verification visit and complaint investigation following a complaint received on 11/16/2023 regarding a resident eloping from the facility on 11/14/2023.
Complaint Details
One of two complaints was substantiated. The complaint involved Resident 1 eloping from the facility on 11/14/2023. Staff failed to respond appropriately to the front door alarm, allowing the resident to exit the building unnoticed. The resident was found in the adjacent church parking lot and returned by a member of the public. The facility's missing resident policy was updated after the incident.
Findings
One of two complaints was substantiated, identifying a repeat deficiency related to inadequate supervision and failure to follow procedures when the front door alarms engaged, resulting in Resident 1 eloping from the building.
Deficiencies (1)
The provider did not ensure adequate supervision for Resident 1, resulting in Resident 1 eloping from the building.
Report Facts
Revisit fee: 200
Temperature: 44
Temperature: 36
Number of complaints: 2
Number of staff working at time: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Laura J. Farah | Surveyor | Named as surveyor conducting the investigation and documenting findings |
| Administrator A | Interviewed regarding elopement incident and investigation | |
| Registered Nurse B | RN | Interviewed regarding elopement incident and staff training |
| Dietary Aid C | Dietary Aid | Staff who shut off the front door alarm speaker but did not check outside |
| Residential Care Coordinator 3 D | RCC3 | Staff interviewed about the incident and response |
| Residential Care Coordinator 3 E | RCC3 | Staff interviewed about the incident and response |
| Residential Care Coordinator F | RCC | Staff involved in resetting the door alarm and responding to the incident |
Inspection Report
Complaint Investigation
Census: 44
Deficiencies: 0
Date: Apr 13, 2023
Visit Reason
The Department conducted a verification visit and complaint investigation at Amery Memory Care following a complaint.
Complaint Details
Complaint was investigated and found not substantiated.
Findings
The complaint was not substantiated and no new violations were identified during the investigation.
Report Facts
Revisit fee: 200
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Feb 1, 2023
Visit Reason
A complaint investigation and verification visit was conducted to determine if Amery Memory Care was in substantial compliance with Wisconsin statutes and administrative codes governing community-based residential facilities.
Complaint Details
The visit was complaint-related and included a verification visit to determine if violations were corrected. The complaint investigation concluded that violations existed as stated in SOD #QKNG13.
Findings
The Department issued a Statement of Deficiency (SOD) #QKNG13 for violations of Wis. Stat. ch. 50 and Wis. Admin. Code ch. DHS 83, resulting in a Notice of Violation and an imposed forfeiture totaling $1700. The licensee was ordered to comply with requirements immediately and provide staff training within 45 days.
Deficiencies (1)
Failure to ensure all resident care staff provide necessary supervision to protect residents' health, safety, and rights.
Report Facts
Forfeiture amount: 1700
Reduced forfeiture amount: 1105
Forfeiture amount: 600
Forfeiture amount: 800
Forfeiture amount: 300
Revisit inspection fee: 200
Compliance timeframe: 45
Payment timeframe: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| William R. Gardner | Assisted Living Regional Director | Contact person for questions about the letter and compliance extension requests |
| Kathleen D. Lyons | Interim Assisted Living Director | Signed the Notice and Order letter |
Inspection Report
Complaint Investigation
Census: 49
Capacity: 68
Deficiencies: 3
Date: Jan 23, 2023
Visit Reason
The Department conducted a verification visit and complaint investigation at Amery Memory Care based on a complaint. Data was collected through 02/01/2023.
Complaint Details
One complaint was substantiated involving inadequate supervision that led to injuries of Resident 4 by other residents entering his/her room.
Findings
Three violations were identified, all repeat deficiencies. One complaint was substantiated involving inadequate supervision leading to injuries of Resident 4 by peers. Medication administration and hand hygiene procedures were also found deficient, with multiple medication errors and failure to follow CDC hand hygiene standards.
Deficiencies (3)
Inadequate supervision for Resident 4 resulting in two incidents where peers entered Resident 4's room causing injury.
Failure to ensure medication administration appropriate to residents' needs, including medication errors and lack of supervision during medication pass.
Failure to follow hand hygiene procedures according to CDC standards by Resident Care Coordinator 3 during medication administration.
Report Facts
Revisit fee: 200
Medication error reports: 6
Medication passer refresher test score: 33
Resident age: 89
Skin tear size: 1.25
Bruise size: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| RCC3 A | Resident Care Coordinator 3 | Named in medication administration and hand hygiene deficiencies; scored 33/45 on medication refresher test; admitted to errors due to going too fast. |
| Administrator E | Administrator | Interviewed regarding incidents and interventions for Resident 4. |
| DON C | Director of Nursing | Interviewed regarding supervision, medication administration, hand hygiene, and training of staff including RCC3 A. |
| Housekeeper D | Housekeeper | Reported observations of medications found in rooms and residents taking medications without supervision. |
| MCW F | Managed Care Worker | Interviewed regarding encouragement of Resident 4's assertiveness and awareness of interventions. |
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